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Hi

I ruptured my achilles in May, however, it was not operated on until 8th July.  I then needed a tendon graft because the gap was so big and was in plaster for almost 9 weeks.  That was probably the most frustrating and hardest time of my life, however, he did take the plaster off 3 weeks earlier than he originally planned.  The plaster came off on 7th September and doctor advised me to weight bear (30%) for a week or so and increase to 50% prior to seeing him again on 5th October.  I am very nervous about putting any weight on it as he did not put me in a boot, nor did anyone demonstrate how to weight bear.  He does not want me to see physio until after 5th as they may be too aggressive!  My foot does swell up and goes purple in colour when not elevated.

Any tips on weigth bearing and should I be worried about not having a boot?

5 Responses to “New to site”

  1. The boot is going to protect you from injuring your foot while in transition. I can’t imagine not having it as it allowed me to go FWB prior to getting into a shoe. I had the same issue with my toes turning purple but little by little that went away as well as the swelling. I’m in week 7 right now and have been in my boot for 3 weeks now and FWB for 2 weeks. I started PT at week 5. I’m told I’ll move to a shoe here in a week or so…

  2. I never had a boot, so it can be done, but it is important to be very careful about anything that could make you slip or lose your balance, or step on anything that could push your toes up higher than they are ready to go.

    I don’t know where you are with your flexibility, but I wasn’t to 90 degrees yet when I started walking in my shoes, so I had to keep my bad foot out front, with weight on the heel only, and shuffle along. Keeping that foot out front at first has the advantage of making it much harder to fall forward over your bad foot. (Assuming your calf doesn’t have the strength yet to hold your weight back, falling forward means you keep going until the Achilles gets stretched too much.)

    Weight bearing on your heel (which does not stress the tendon) and bearing weight on the front of your foot (which does stress your tendon) are very different things. It’s the weight on the front of your foot that you need to be really careful about.

    Boots do protect you, but they slow down your progress, too. A reasonable compromise may be to use a boot when you are concentrating on other things, (and therefore more likely to injure yourself with a misstep), and save walking in your shoes for when your walking has your full attention, in a safe place.

    I hope this helps,

    Doug

  3. 9 weks post-op your tendon should be getting pretty strong. I was already 3 weeks back into 2-shoes by that time, after working up to FWB in the boot before 4 weeks post-op.
    Like the others have said, the boot gives you protection from re-injury, but you should need it much less now at 9 weeks than those of us who went into them early.
    As Doug said, save walking in 2-shoes for when walking has your full attention. That attitude worked for me without going back to the boot: I just made sure I always paid full attention while walking for the first few weeks. Anywhere the ground is uneven, I still treat walking with respect (at 11 weeks now).
    Dylan

  4. Indeed some PT are too aggressive, that is why surgeons maybe weary of them. But maybe your toes are turning purple because you do not move them at all. Even if you do not do physio, try to wiggle them and gently move your ankle to get the stiffness out and improve your range of motion after 9 weeks in the plaster.

    Check sam66 blog, she was in plaster for 9 weeks and no boot afterwards.

  5. Hi,
    I was worried about not having a boot initially, but the surgeon said it wasn’t necessary after the full 9 weeks in cast. Asked physio too and she said if I was having a boot it should’ve been for the last few weeks instead of plaster. So after 9 weeks in cast it was straight into 2 shoes with 2 crutches, hence still only calling myself PWB.
    Assume you were shown how to walk with crutches? Physio double-checked I was using the crutches properly and showed me how to do stairs with them - have mentioned some of this on my blog with the exercises I was given.
    I’m not getting too much swelling now and toes are only a funny colour first thing in the morning after a night of elevation. Walking albeit slowly and with crutches is helping the circulation and I am getting slightly more confident on the weight-bearing all the time, just by feeling how much feels safe. Knee is also weak and locks easily or threatens to give way if I put too much weight on it.
    Seems a shame you aren’t to see physio till after surgeon’s check-up as you could be doing all the ROM exercises and minor stretching etc now.
    I had my first physio the same day as the cast came off and it was useful to have even those very limited exercises to get started with, not at all aggressive.
    The first few weeks out of cast are quite worrying so do be careful and obviously I’m not a surgeon or physio, but some limited ROM exercises would surely help. Perhaps your surgery was very complicated - but there are others that have had grafts etc who started physio sooner than you will.
    Best of luck,
    Sam

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